Navigated pedicle screw placement: Experimental comparison between CT- and 3D fluoroscopy-based techniques

Abstract

The overall image-to-reality accuracy for CT- and Iso-C-based navigation was assessed in the described experimental setup. An apparent tendency towards higher accuracy with Iso-C-based navigation was evaluated; however, the differences were not significant.

Intraoperative navigation for accurate midline placement of anterior lumbar interbody fusion and total disc replacement prosthesis

“…The main cause of these poor outcomes include incorrect sizing of implants, incorrect indications for surgery and malpositioning of the implant (14,18). An implant must be placed accurately at the midline for optimum function, durability and clinical outcomes (8,10,11,14). If the positioning of the device is not correct, complications can arise such as coronal tilt and scoliosis, abnormal loading of the facet joints and adjacent disc degeneration (14).…”

“…An alternative is intraoperative spinal navigation using 3-dimensional (3D) computed tomography (CT). CT-based navigation has been shown to reduce radiation exposure for the surgeon, and improve spinal visualization, allowing more accurate placement of an instrumentation device (8,10,11). Accurate midline placement of a replacement disc is particularly important for its optimal biomechanical function and longevity (12,13).…”

The use of intraoperative neuroimaging tools and a navigation system in surgical treatment of primary and metastatic tumors of the spine

“…Хирургическое лечение опухолей позвоночника сопряжено с высоким риском таких интраопераци-онных осложнений, как повреждение спинного мозга и его корешков, а также крупных сосудов как в процессе удаления опухоли, так и на этапе стаби-лизации при имплантации педикулярных или кор-поральных винтов [1][2][3][4]. В литературе, посвящен-ной хирургии позвоночника, причиной подобных осложнений считаются измененная топографиче-ская анатомия и нарушение традиционных ориен-тиров в результате литического процесса в костной ткани и роста опухоли.…”

Focus on spinal navigation

“…CT-fluoro-matching as well as surface matching resulted in high precision, but were sometimes demanding and time-consuming. Each vertebra had to be addressed by separate matching, especially if unstable fractures had to be instrumented [2,3].…”